ESP-ROS-70

Code
ESP-ROS-70
Mercy ID
V-01970-01
Encounter Date
07/11/2005
Last
Ezpino
First
Maria rosa
DOB
10/07/1970
County
Dekalb
Street
3179 Shadow Walk Lane
City
Tucker
State
GA
Zip
30084-
Home
(770) 948-5634
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Martinez
First
Pedro
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
No
Alcohol & Drug
No
Partner Referred to Tepestri
No
Recidivism/Court
No
New Incident
No
Promesa de Confidencialidad
No
Consentimiento De Participar
No

Petitioner

TPO
No
Stay Away Condition
No
Mutual
No

Defendant

TPO
No
Stay Away Condition
No
Mutual
No
Driver
YES
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Alicia Garcia 11/02/1990 Mother w/Stepfather GA/USA
Jorge Garcia 07/15/1992 Mother w/Stepfather GA/USA
Oscar Omar Garcia 05/01/1988 Father GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
K. Aleman
Referred By
Rafael